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Urinary Exam 2 > Regulation of Renal Transport > Flashcards

Regulation of Renal Transport Flashcards

1
Q

Urine pH range:

A

4.5-8.0 depending on diet

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2
Q

In what form are H+ ions secreted in the nephron?

A

Trap it in ammonia and phosphate ions

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3
Q

Early proximal convoluted tubule S1 cell H+ and HCO3- transport:

A

Apical: HCO3 -> CO2 + H2O (breaks it down CO2 and H20 diffuse across)
Basolateral: Na/HCO3- cotransporter

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4
Q

Late proximal convoluted tubule S3 cell H+ and HCO3- transport:

A

Apical: NHE and H+ ATPase pump
Basolateral: HCO3-/Cl- exchanger and Na/HCO3- cotransporter

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5
Q

TAL H+ and HCO3- transport:

A

Apical: NHE and H+ ATPase pump
Basolateral: HCO3-/Cl- exchanger

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6
Q

Alpha intercalated and medullary collecting-duct H+ and HCO3- transport:

A

Apical: NHE and H+ ATPase pump and K/H ATPase
Basolateral: Na/HCO3- cotransporter and HCO3-/Cl exchanger

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7
Q

What do alpha intercalated cells do?

A

Excrete H+ via H/K ATPase (K+ in H+ out) and H+ ATPase and reabsorb HCO3-

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8
Q

What do beta intercalated cells do?

A

Absorb H+ and secrete HCO3-

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9
Q

When urine is acidic what types of drugs tend to be reabsorbed?

A

Weak acid drugs

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10
Q

When urine is alkaline what types of drugs tend to be reabsorbed?

A

Weak basic drugs

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11
Q

What type of urine does meat cause?

A

Acidic urine

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12
Q

What food causes more basic urine?

A

Foods rich in carbohydrates

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13
Q

What affects does aldosterone have on Na+ transport?

A

Increase apical ENaC channel expression

Increase basolateral Na/K pump

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14
Q

Effect of guanylin peptides?

A

Diuresis: increase cGMP

decreased Na+ reabsorption by decreased K+, Na/K, N/H channels

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15
Q

Effect of prostaglandin/bradykinin?

A

Diuresis: decreased K+ and ENaC

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16
Q

Effects of dopamine?

A

Natriuresis: decreased NHE and Na/K

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17
Q

What is the neurohormonal gastrointestinal renal axis?

A

Fluid and solute intake in the gut cause release of gut-derived factors that affect the kidney

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18
Q

What are some neurohormones released from the gut?

A

Guanylin
Uroguanylin
Glucagon-like peptide 1 (GLP-1)

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19
Q

Agonists of guanylate cyclases in the kidney?

A

STa
GN
UGN

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20
Q

Two signaling pathways for guanylin peptides in proximal tubule?

A

GC-C: increased water secretion AQP-1 (diuresis)

cGMP dependent: decreased Na+ reabsorption (natriuresis)

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21
Q

Guanylin peptide signaling in principal cells of the CCD?

A

Activate phospholipase A2 to increase arachidonic acid concentration and inhibit Na+ channels and AQP 2, 3, 4

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22
Q

Where does dopamine cause diuresis?

A

PCT

TAL

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23
Q

PCT phosphate handling:

A

Apical: Na+/HPO4- and
H2PO4-/Na+ absorption via NaPi-IIa
Basolateral: not yet known

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24
Q

What does PTH cause?

A

Increased phosphate excretion

Decreased phosphate reabsorption

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25
What does calcitonin cause?
Increased phosphate excretion | Decreased phosphate reabsorption
26
Two signaling pathways of PTH?
G-alphas: activates adenylyl cyclase -> cAMP -> PKA G-alphaq: PLC -> PKA both remove NaPi-IIa from apical membrane
27
ANP signaling pathway?
PKG activation to remove NaPi-IIa from apical membrane
28
Calcium reabsorption in proximal intestine?
Apical: calcium channels Basolateral: Ca++ ATPase and Na/Ca antiporter exchanger
29
How are calcium intracellular levels kept under control?
Ca++ entering at the apical membrane will increase the microenvironments levels causing a binding of Ca++ to calbindins, as Ca++ is pumped out the basolateral membrane the microenvironment decreases in concentration causing a release of Ca++ from calbindin
30
Vitamin D effect?
Calcium absorption
31
Hepatic Vitamin D metabolism?
Vitamin D is carried through blood via D-binding protein to the liver and metabolized via CYP27A1 or CYP2R1 to active 25 (OH)2-vitamin D where it is filtered in kidney and picked up by apical megalin receptors
32
Renal vitamin D metabolism?
Megalin picks up 25 (OH)2-vitamin D and converts it to active 1,25(OH)2-vitamin D shipped to target organs via DBP
33
What channel is needed for Ca to be absorbed in the intestinal apical membrane?
TRPV6
34
What does vitamin D regulate the transcription of?
TRPV6 | PMCA
35
What does calcium use to be transported out the basolateral membrane of the intestines?
PMCA | NCX
36
Calcium channels in PCT?
Apical: passive Ca channel entry Basolateral: NCX and PMCA
37
TAL calcium channels?
Apical: passive Ca channel (TRPV6) Basolateral: PMCA
38
DCT calcium channels?
Apical: passive Ca channel (TRPV6) Basolateral: NCX
39
Where is calcium actively secreted in the nephron?
NOWHERE in the nephron
40
What is the negative feedback mechanism for PTH?
CaSR receptors monitor serum calcium levels that cause a generation of arachidonic acid metabolites which inhibit the release of PTH and increase expression of vitamin D receptors (VDR) which increases cell's sensitivity to negative feedback exerted by 1,25(OH)2-vitamin D
41
How does PTH increase GI calcium uptake?
Stimulates activation of intermediate form of vitamin D to calcitriol in the kidney to uptake GI calcium
42
What secretes calcitonin?
C cells in the thyroid
43
What does calcitonin cause?
Osteoblast bone formation | Osteoclast decreased bone resorption
44
How is Mg reabsorbed in the PCT?
Solvent drag paracellularly
45
What is the major factor in creating the transepithelial voltage gradient in TAL?
NKCC
46
What is needed for Mg paracellular route in the TAL?
Paracellin-1
47
What increases Mg reabsorption TAL?
cAMP | PKA
48
What decreases Mg reabsorption in the TAL?
Decreased transepithelial mV
49
What channels in principal cells secrete potassium?
Na/K pump K channel K/Cl symporter
50
How does acidemia cause hyperkalemia?
Exchanges intracellular K for extracellular H displacing K into the interstitium
51
What does acidemia cause?
Hyperkalemia
52
What does acidosis cause?
Decreased K+ secretion
53
How does acidosis cause decreased K+ secretion?
Decreased basolateral Na/K pump | Decreased K channel gating and permeability
54
What does alkalosis cause?
Increased K+ secretion
55
How does alkalosis cause increased K+ secretion?
Increased basolateral Na/K pump Increased K+ channel gating and permeability Increased K/Cl symporter
56
Epinephrine/catecholamine affect on K+?
Decreased K+ secretion: increased K+ extra-renal tissue uptake and decreased secretion
57
AVP/ADH affect on K+?
Increased K+ secretion
58
How does AVP/ADH cause increase K+ secretion?
Increase apical Na+ conductance depolarizing apical membrane and providing a larger driving force for K+ efflux (pushing K+ out of the cell)
59
What is the most potent stimuli for K+ secretion?
Rate of fluid flow in the lumen; more fluid = more K+ secretion
60
Why does increased flow cause increased K+ secretion?
Because the apical membrane of principle cells is highly K+ permeable; if flow is low then a concentration of K+ builds up in the lumen and less of a driving force exists for K+ to leave the cell; when flow is high there is a low K+ concentration bc it is constantly being swept away
61
What does high HCO3- levels cause?
Hypokalemia levels by stimulating K+ transfer into cells
62
What substances buffer hyperkalemia?
Insulin Epinephrine Aldosterone
63
How do insulin, epinephrine and aldosterone buffer hyperkalemia?
By promoting transfer of K+ from extracellular to intracellular via Na/K pump
64
What can lack of insulin or RAS cause?
Hyperkalemia by not allowing cells to uptake K+
65
What can administering beta-adrenergic blockers cause?
Hyperkalemia by not allowing cells to uptake K+

Urinary Exam 2 (16 decks)

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